DOI: 10.4274/Tjh.2013.0207
Letter to the Editor
Lenalidomide-Induced Pure Red Cell Aplasia Lenalidomid ile Uyarılmış Eritroid Dizi Aplazisi Tuphan Kanti Dolai, Shyamali Dutta, Prakas Kumar Mandal, Sandeep Saha, Maitreyee Bhattacharyya NRS Medical College and Hospital, Department of Hematology, Kolkata, India
To the Editor, Pure red cell aplasia (PRCA) is a bone marrow failure disorder. Several drugs have been reported as having induced PRCA, but lenalidomide-induced PRCA is rarely reported. Here we present a patient with myelodysplastic syndrome (MDS) who developed PRCA after treatment with lenalidomide. A 47-year-old male presented with a history of weakness with effort intolerance for 5 months. Examination showed pallor and mild splenomegaly. Blood count showed Hb level of 86 g/L, total WBC count of 5.2x109/L, normal differential counts, and platelet count of 223x109/L. MCV was 101 fL and reticulocyte count was 1%. Serum chemistries were normal. Bone marrow aspiration and biopsy results showed mild hypercellularity with evidence of megaloblastic erythropoiesis and dyserythropoiesis. Cytogenetics showed loss of the Y chromosome. Iron stores were normal. Serum B12, folic acid, and serum ferritin levels were normal. Tests for antinuclear antibodies, HIV-1 and HIV-2 antibodies, hepatitis B surface antigen, and anti-hepatitis C virus were negative. Expressions of CD55 and CD59 on granulocytes were in the normal range. He received vitamin B12 with no success. With the diagnosis of MDS with refractory anemia, he was started on lenalidomide at 5 mg daily. In the next 3 weeks, he presented with severe weakness and the Hb level dropped to 53 g/L with normal WBC and platelets. Reticulocyte count was
Letter to the Editor
Lenalidomide-Induced Pure Red Cell Aplasia Lenalidomid ile Uyarılmış Eritroid Dizi Aplazisi Tuphan Kanti Dolai, Shyamali Dutta, Prakas Kumar Mandal, Sandeep Saha, Maitreyee Bhattacharyya NRS Medical College and Hospital, Department of Hematology, Kolkata, India
To the Editor, Pure red cell aplasia (PRCA) is a bone marrow failure disorder. Several drugs have been reported as having induced PRCA, but lenalidomide-induced PRCA is rarely reported. Here we present a patient with myelodysplastic syndrome (MDS) who developed PRCA after treatment with lenalidomide. A 47-year-old male presented with a history of weakness with effort intolerance for 5 months. Examination showed pallor and mild splenomegaly. Blood count showed Hb level of 86 g/L, total WBC count of 5.2x109/L, normal differential counts, and platelet count of 223x109/L. MCV was 101 fL and reticulocyte count was 1%. Serum chemistries were normal. Bone marrow aspiration and biopsy results showed mild hypercellularity with evidence of megaloblastic erythropoiesis and dyserythropoiesis. Cytogenetics showed loss of the Y chromosome. Iron stores were normal. Serum B12, folic acid, and serum ferritin levels were normal. Tests for antinuclear antibodies, HIV-1 and HIV-2 antibodies, hepatitis B surface antigen, and anti-hepatitis C virus were negative. Expressions of CD55 and CD59 on granulocytes were in the normal range. He received vitamin B12 with no success. With the diagnosis of MDS with refractory anemia, he was started on lenalidomide at 5 mg daily. In the next 3 weeks, he presented with severe weakness and the Hb level dropped to 53 g/L with normal WBC and platelets. Reticulocyte count was
